Policyholder Services



Additional Benefits Included in OMIC’s Professional Liability Policy

Welcome to OMIC’s Additional Benefits information page. Coverage for the following exposures is included in OMIC’s standard professional liability policy at no additional premium.

Disciplinary Proceeding Protection – Section VII.A.

OMIC will defend and pay legal expenses for insured ophthalmologists for investigations, disciplinary proceedings, or actions for review by any federal, state, or local regulatory agency arising from a patient complaint of an injury due to direct patient treatment. OMIC will pay $25,000 per proceeding and $75,000 for all proceedings per policy period.

Broad Regulatory Protection and e-MD® Coverage – Sections VII.B. and C.

OMIC provides 16 BRP and e-MD® benefits subject to a per policy period limit of $100,000 per claim and in the aggregate. For a summary of these benefits, scroll down to the table. For a detailed description of some of the major benefits, follow the links below.

General Information about BRP/eMD® Coverage Benefits 

Billing Errors (“Fraud and Abuse”) Allegations
HIPAA/HITECH Privacy Violations
Other Regulatory Exposures (DEA, Stark Act, EMTALA Investigations)
BRP Licensure Actions
Peer Review
Cyber Liability and Network Vulnerabilities (e-MD®)

To purchase higher limits than what is already included in your OMIC malpractice policy, or if you are not an OMIC insured but would like to purchase this benefit package as a stand-alone product, contact NAS Insurance Agency. Visit OMIC’s Coverage Q&A page for answers to other coverage questions.

Broad Regulatory Protection (“BRP”) – Section VII.B.

Reimburses insureds for the 7 regulatory proceedings listed below ($100,000 limit**):

Coverage

For

Legal expenses

Audit Expenses

Fines & Penalties

Billing Errors Proceeding

Qui tam (whistleblower), government, or commercial payer proceeding

X

X

X

DEA Proceeding

Drug Enforcement Agency action re ability to prescribe drugs that require a DEA license

X

EMTALA Proceeding

Government action for violation of Emergency Medical Treatment and Active Labor Act

X

X

HIPAA Proceeding

Government action for violation of HIPAA privacy and security regulations

X

X

Covered Licensing proceeding

State licensing action related to ophthalmology practice (but not direct patient treatment)

X

STARK Proceeding

Government action for violation of anti-kickback or self-referral laws

X

X

Peer Review

Actions against insured by review body of a hospital/other health care facility affecting privileges

X

 

e-MD® – Section VII.C.

Provides the 9 cyber liability coverages listed below ($100,000 limit**):

Coverage

For

Type of Claim

Pays

Pays

Multimedia Liability

Release or display of electronic or print media display that results in defamation, invasion of privacy, plagiarism, or copyright infringement

Pay on behalf

Legal expense

Loss (money an insured is legally obligated to pay)

Network Asset Protection: Loss of Digital Assets

Digital assets (data/ programs that exist in insured’s computer system; not hardware) loss due to accidental damage, crime the insured failed to prevent, etc., that causes damage, theft, or misuse of the insured’s digital assets

Pay

Restoration of digital assets (inc. materials, machine time, and employee expense)

Special expenses (to mitigate further damage)

Network Asset Protection: Non-Physical Business Interruption and Extra Expense

Accidental damage, crime the insured failed to prevent, etc., that causes interruption, degradation, or failure of insured’s computer system

Pay

Income loss and interruption expenses (to avoid or minimize suspension of business)

Special expenses (to mitigate further damage)

Cyber Extortion

Threat to release confidential information of third party from, corrupt, or restrict access to, insured’s computer system

Pay

Expenses incurred as a result of threat

Monies insured pays to terminate threat

Cyber Terrorism 

Act of cyber (not physical) terrorism that causes interruption, degradation, or failure of insured’s computer system

Pay

Income loss and interruption expenses (to avoid or minimize suspension of business)

Special expenses (to mitigate further damage)

Security and Privacy Liability

Claim for security and privacy wrongful act

Pay on behalf

Legal expense

Loss (money an insured is legally obligated to pay)

Security and Privacy Regulatory Defense and Penalties

Government proceeding based on a security or privacy breach

Pay on behalf

Legal expense

Regulatory: fines & penalties or compensatory award

Security and Privacy Breach Response Costs, Notification Expense, and Support and Credit Monitoring Expense

Due to security or privacy breach, employing a public relations consultant to prevent or mitigate damage to the insured’s reputation or brands because of an adverse media report; notifying affected individuals; credit file monitoring and identity theft assistance (due to privacy breach)

Pay on behalf

Expenses (see coverage “For”)

BrandGuard®

Adverse media report or notification of privacy or security breach

Pay

Lost income

PCI DSS Assessment

Noncompliance with a Payment Card Industry Security Standard that results in a security or privacy breach

Pay on behalf

Legal expense

Fines & penalties assessed by bank or card association

 

** There is one $100,000 limit for any and all BRP and e-MD® claims per policy period.

Extended Reporting Period

BRP and e-MD® include a two year extended reporting period if the insured acquires tail coverage for the policy. However, the extended reporting period does not increase the limit of liability; it is shared with the prior policy period.

Who Is Insured

OMIC provides free BRP and e-MD® coverage for OMIC physician and entity policyholders only. OMIC-insured optometrists can purchase the coverage.

Please refer to OMIC's Copyright and Disclaimer regarding the contents on this website

Leave a comment



Six reasons OMIC is the best choice for ophthalmologists in America.

#2. Leader in the industry.

A-rated by AM Best, OMIC is ranked #1 among 50 malpractice insurance companies in America for financial stability. No other carrier has matched OMIC's consistent financial performance with regard to both combined and operating ratios, the two most relevant financial measurements for an insurance carrier.

61864684